There was a point in time when I believed I was what might be called a “centrist” Democrat. I was just getting interested in political concerns following the first two years of the Bill Clinton administration. He and the Democratic-controlled Congress had managed to pass their first budget which, like George H. W. Bush before him, had been an attempt to try to correct the growing federal deficit by increasing the top marginal rate to 39 percent after it had been previously slashed under Reagan from 70 percent, to 50 percent, and then down to just 28 percent.
It was a time when Democrats had implemented the first-ever assault weapons ban and the headlines were dominated by the deadly tragedies of the Waco Siege, the first World Trade Center attack, and the Oklahoma City Bombing. I believed that every idea had its own inherent merit and it shouldn’t matter what the roots of the idea were, or which person or party had conceived it. What should matter was whether it was a good idea that was more likely to accomplish its goal with a minimum of negative side effects or collateral damage.
I essentially agreed with Bill Clinton’s idea of centrism, or “third way” politics, where the ideas of both the left and the right were considered and where they could be implemented without regard to ideological purity or party perfection.
Then came the Gingrich revolution, and he and the GOP swept into the House along with his “Contract with America.” I didn’t understand who these people were. I didn’t know why they were so massively angry, or why they seemed to be so mean, following Gingrich’s own philosophy of “going negative” and using certain words to paint the opposition as being “bizarre, cheats, corrupt, destructive, a disgrace, incompetent, insensitive, radical, selfish, shallow, sick, traitors.”
It was clear that this new crop of Republicans wasn’t concerned with whether any particular idea was actually “good.” They were absolute ideological purists, crusaders, and warriors against the dangerous anti-gun, pro-tax liberal hordes. It was probably the last time that our government was even partially functional.
As the years have gone on, both of those perspectives have changed and shifted both in theory and in practice. Centrism, as I understood it at the time, changed from being a perspective where all ideas where evaluated on their merits rather than their sourcing. Instead, it slowly shifted into the hunt for appealing to the middle where bold and dynamic idea were instead painted—certainly with the help of the Gingrich-ites—as being “extreme and radical.”
Rather than attempting to simply open up Medicare and Medicaid as programs that were available to all, then-first lady Hillary Clinton attempted to craft a health care plan behind closed doors and without the input of Congress. The plan was seen as highly rigid and seemingly impossibly complex. In reality, it was far more flexible and market-based than what eventually became the Affordable Care Act under President Obama.
That plan was largely based on the idea of increasing access largely by bringing down costs. This was accomplished by establishing standards with which every insurance provider would be measured against. There would be a national set of measurements which each individual state could use as a template and customize locally as they saw fit. In order to further foster competition, each state would then establish two associations (which would be equivalent to an ACA exchange) which would allow individual insurance purchasers to gain bulk-rate pricing by having an economy of scale. These associations would produce a report card on each provider based on the measurements which had been established by that state.
There was no individual or employer mandate. [This was included.] There was no public option. There was no Medical Loss Rate. All of the providers would be private, and all price controls would be based on buyer choice.
Republican leaders, including Gingrich and Bob Dole, saw this idea as a massive “government take-over” of health care. They used the complexity of the plan to demonize it as un-American. They argued that the boards for developing the standards of non-profit associations were all brand-new government agencies (totaling over 150, as there would be one board and two associations per state). Bob Dole offered his own alternative crafted by the Heritage Foundation, which simplified the two associations into one exchange and also included the individual mandate, which conservatives felt was a matter of taking “personal responsibility” for ones own health care.
The plan was introduced in a 1989 book, "A National Health System for America" by Stuart Butler and Edmund Haislmaier. We seem to have mislaid our copy, and we couldn't find it online, but we did track down a 1990 Backgrounder and a 1991 lecture by Butler that outline the plan. One of its two major planks, the equalization of tax treatment for individually purchased and employer-provided health insurance, seemed sensible and unobjectionable, at least in principle.
Stuart Butler’s lecture describes what the Heritage’s mandate would look like:
We would include a mandate in our proposal--not a mandate on employers, but a mandate on heads of households--to obtain at least a basic package of health insurance for themselves and their families. That would have to include, by federal law, a catastrophic provision in the form of a stop loss for a family's total health outlays. It would have to include all members of the family, and it might also include certain very specific services, such as preventive care, well baby visits, and other items.
Of course Dole was never serious about offering this plan for consideration or a vote. He simply adopted the Heritage template just to be able to make the claim that Republicans had “an alternative” to HillaryCare, but when Hillary’s own plan collapsed under the weight of its own complexity, the Heritage plan was dropped and shelved until being dusted off by Mitt Romney in Massachusetts. It went on to be used as the primary template for the Affordable Care Act.
Romney and Gingrich actually argued about this plan face-to-face during a presidential debate 20 years later as they both ran against Barack Obama and Hillary Clinton. [The relevant sections starts at 27:38.]
ROMNEY: Actually, Newt, we got the idea of an individual mandate from you.
GINGRICH: That's not true. You got it from the Heritage Foundation.
ROMNEY: Yes, we got it from you, and you got it from the Heritage Foundation and from you.
GINGRICH: Wait a second. What you just said is not true. You did not get that from me. You got it from the Heritage Foundation.
ROMNEY: And you never supported them?
GINGRICH: I agree with them, but I'm just saying, what you said to this audience just now plain wasn't true.
(CROSSTALK)
ROMNEY: OK. Let me ask, have you supported in the past an individual mandate?
GINGRICH: I absolutely did with the Heritage Foundation against Hillarycare.
ROMNEY: You did support an individual mandate?
ROMNEY: Oh, OK. That's what I'm saying. We got the idea from you and the Heritage Foundation.
GINGRICH: OK. A little broader.
ROMNEY: OK.
Two years later when the ACA became law, Republicans were again enraged by the idea of the individual mandate—even though it had been their own idea that came from Heritage, had been promoted by Gingrich and Dole, and implemented by Romney and then by Barack Obama.
Their own idea became the worst idea in the world as soon as it was adopted by Obama, who actually was also against it during the 2008 campaign (Hillary Clinton who favored it). The idea was called “leftist” and “socialist” and “un-American,” just as HillaryCare had been.
It wasn’t about whether the idea was any good or whether it was bad: It was now a “liberal idea,” a “leftist idea.” It was “corrupt, radical, destructive, sick.”
The fact that nearly 20 million Americans gained access to health care which they didn’t previously have didn’t matter, as the GOP then voted 54 times to overthrow the ACA. The facts no longer mattered. Reality no longer mattered. The people no longer mattered—only the argument mattered. Only the GOP strategy of demonization and marginalization mattered. “Owning the libs” mattered, even if it meant those 20 million Americans would be thrown to the winds.
Back in the early days of Gingrich and his battles against Bill and Hillary, I first began reading and posting within political forums online. In those long-ago days I would often debate and argue with conservatives as the forums were general and not specific to a particular party or ideology. Those debates were critical to sharpening my own thought processes about the direction of America. I found that any particular preconception I might have could be flawed, and that any particular concept someone else might have could also have flaws. In theory, testing our ideas against each other, making sure that you cover every base and address things thoroughly, was crucial to being able to potentially bring someone else into an agreement. We didn’t necessarily start with the answer to a problem and then work backward to justify that answer: we worked forward through several potential answers to find the one that worked best.
Those days are clearly long gone.
The right now has their answer to every question: tax cuts. And walls. We don't have open debate anymore because now we’re dealing with a cult.
Today we again see them attacking any idea that comes from the “radical left,” including the Green New Deal and Medicare for all. But the attacks aren’t just coming from the right, they’re also coming from so-called “centrist” Democrats like Joe Manchin and the media’s darling new “reasonable” Democrat, Sen. Amy Klobachar. And also, of course, alleged Independent Howard Schultz, who somehow managed to get his own presidential town hall on CNN even though he hasn’t declared that he’s running for president yet. Here’s billionaire Starbucks CEO Schultz defending his attacks on Medicare for all.
"Why do you think Medicare-for-all, in your words, is not American?" CNN's Poppy Harlow asked Schultz on Tuesday.
"It's not that it's not American," Schultz said. "It's unaffordable."
"What I believe is that every American has the right to affordable health care as a statement," Schultz said, lauding the Affordable Care Act, otherwise known as Obamacare, as "the right thing to do."
He added, "But now that we look back on it, the premiums have skyrocketed and we need to go back to the Affordable Care Act, refine it and fix it."
He argued that the Democratic progressive platform of providing Medicare, free college education and jobs for everyone is costly and as "false as President Trump telling the American people when he was running for president that the Mexicans were going to pay for the wall."
Sanders said, "Let me thank the Koch Brothers of all people for sponsoring a study that shows that Medicare for All would save the American people $2 trillion over a 10-year period. … That is what is in the study of the Mercatus Center."
Schultz response to this was just three words: “It’s not true.” He can accept the $32 trillion estimate, but he can’t accept a $2 trillion savings which comes from the exact same report? And again, that was the worst-case scenario.
A better scenario from the
Urban Institute argued that Bernie Sanders’ plan would generate $15.3 trillion in additional revenues over 10 years, according to the Tax Policy Center.
Analysis by the Tax Policy Center indicates that Sanders’s revenue proposals, intended to in once all new health and non health spending, would raise $15.3 trillion in revenue over 2017 to 2026.
They claim this wouldn’t be enough to cover the $32 trillion cost.
This amount is approximately $16.6 trillion less than the increased federal cost of his health care plan estimated here.
However, they seem to magically forget that Sanders’ plan doesn’t repeal current taxes for Medicare, Medicaid, and ObamaCare (ACA), which a UMass study indicates already generates $18 trillion over 10 years.
Public health care revenue sources that presently provide about 60 percent of all U.S. health care financing, including funding for Medicare and Medicaid, would provide $1.88 trillion of financing for the new system.
The math is simple: $18.8 trillion in current Medicare/Medicaid taxes plus $15.3 trillion in additional taxes happens to be $34.1 trillion, which is certainly enough to meet the demand of $32 trillion—with money to spare.
So it’s not “too expensive,” particularly when the Urban institute also says that Sanders’ plan would generate $22 trillion in savings from current private sector costs. That means that instead of individuals and businesses spending $22 trillion for private care, those needs would be met by Sanders’ $15.3 trillion in taxes. That’s an additional savings of $7 trillion on top of the initial $3 trillion in savings estimated by the Koch-funded study, for a grand total of $10 trillion in savings.
Scenario No. 3, which comes from Sanders himself, is that the overall cost of health care if provided via Medicare (which is an average of 30 percent cheaper than private care) would drop from $32 trillion down to $29 trillion. This would still generate savings of another $3 trillion over 10 years, on top of the $7 and $3 trillion from the previous two studies.
The PERI research team of Pollin, James Heintz, Peter Arno, Jeannette Wicks-Lim and Michael Ash, found that Medicare for All would reduce annual health care spending to $2.93 trillion from the current level of $3.24 trillion
All of these studies agree on the basic numbers and requirement of $32 trillion over 10 years. It would be fair to argue about the quality of care this type of system would provide and to argue about whether this plan would save $3 trillion (according to Koch/Mercatus), $10 trillion (according to the Urban Institute) or $6 - $13 trillion (according to UMass/Sanders) depending on whether the $7 and $6 Trillion in savings I identified above from Urban Institute and UMass respectively are duplications since they are both cost savings from replacing private care costs with a public system or not, but it’s not reasonable to just claim “It’s too expensive” or “It’s not true.”
Instead of having that debate or having a serious discussion about the Green New Deal, we get things like this from so-called “centrists” like Joe Manchin.
I am skeptical that single-payer is the right solution, but I believe that the Senate should carefully consider all of the options through regular order so that we can fully understand the impacts of these ideas on both our people and our economy," Manchin said in a statement Tuesday.
"Let it go through the committee, let it go through the process. I don't just know enough about it. I'm not signing on to a piece of legislation that I don't have any idea what it's going to do to the economy, to the access and to people's care," he told The Hill.
Or “centrists” like Amy Klobuchar.
When Cooper asked whether she supported "Medicare-for-all," Klobuchar replied, "I want to see universal health care, Anderson, and there are many ways to get there."
The senator said she supports expanding Medicaid and Medicare, but she did not commit to overhauling private insurance.
"The smartest transition right now would be to do a public option, and you could do it by expanding Medicaid, you can expand Medicare," Klobuchar added. "I'm on both bills that do that, and that's going to get us more quickly, I believe, to where we need to go."
When pressed on whether she supported a Medicare-for-all approach in particular, Klobuchar replied, "I'm happy to look at it as an option, but I'm not on that bill right now."
To me being a centrist meant being open to ideas—all ideas, hard left ideas, even Republican ideas, as long as they had some merit. We’ve already tried the ACA, and it’s time to move the ball down the field.
Scientists absolutely back up what Alexandria Ocasio-Cortez has said about only having 12 more years before the current climate change situation becomes critical. We need to take that threat seriously.
Now we have these “centrists” who are simply timid and afraid, beaten down by a generation of being called “radical” and “socialist” over every issue, even when they’re going with a Republican idea.
Under Clinton we were bold enough to implement an assault weapons ban. We were bold enough to raise taxes all the way back to 39 percent, which resulted in a balanced budget for the first time since Eisenhower. Back then maybe we wouldn’t have been cowed by the ideas presented by Alexandria Ocasio-Cortez and Elizabeth Warren of bringing the top marginal tax rate back up to 70 percent—where it was during the Kennedy, Johnson, Nixon, Ford, and Carter administrations before Reagan cut it and started the era of deficits as far as the eye could see.
We need to be that bold again, no matter what names we’re called. We have to do what needs to be done to save the people of this nation and save this planet.
But that no longer means being a centrist. It’s time to be a bit more radical.